QIPP: An Overview

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QIPP: An overview

Elizabeth Foley
10 November 2010

BAOT Lifelong Learning Event

Published in: Health & Medicine
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  • We have become used to growth and to the NHS doing well in comprehensive spending reviews:
    in the period between 1997 and 2009 NHS Spend grew by 5.7% in real terms each year. This translates to around £60bn extra resources per year.
    Even now until 2011 we will continue to have NHS funding fixed at relatively high levels
    However two unavoidable forces are now coming together to give us unprecedented challenges. 
    Firstly, public expectations of the safety and quality of care are rocketing. 
    And secondly, the economic recession is leaving the Government in such heavy debt that public spending will have to be radically reined back for years to come.
  • We have become used to growth and to the NHS doing well in comprehensive spending reviews:
    in the period between 1997 and 2009 NHS Spend grew by 5.7% in real terms each year. This translates to around £60bn extra resources per year.
    Even now until 2011 we will continue to have NHS funding fixed at relatively high levels
    However two unavoidable forces are now coming together to give us unprecedented challenges. 
    Firstly, public expectations of the safety and quality of care are rocketing. 
    And secondly, the economic recession is leaving the Government in such heavy debt that public spending will have to be radically reined back for years to come.
  • We have become used to growth and to the NHS doing well in comprehensive spending reviews:
    in the period between 1997 and 2009 NHS Spend grew by 5.7% in real terms each year. This translates to around £60bn extra resources per year.
    Even now until 2011 we will continue to have NHS funding fixed at relatively high levels
    However two unavoidable forces are now coming together to give us unprecedented challenges. 
    Firstly, public expectations of the safety and quality of care are rocketing. 
    And secondly, the economic recession is leaving the Government in such heavy debt that public spending will have to be radically reined back for years to come.
  • QIPP: An Overview

    1. 1. QIPP: An Overview Elizabeth Foley 10 November 2010
    2. 2. Overview • QIPP is the key • AHPs are the solution • Liberating the NHS • Are you up for it?
    3. 3. Background • National Work • AHP matrix
    4. 4. • QIPP overview • NHS Yorkshire and the Humber
    5. 5. The approach in Yorkshire and Humber Phase one: Mobilisation • Numerous network meetings • QIPP Resource Packs • Better for Less briefings • Leadership events Phase two: Implementation • Mainstreaming QIPP into core business • Regional workstreams • Grip and pace
    6. 6. 6 Our approach – regional workstreams T-health Regional Telehealth Hub Regional Telemedicine Stroke resource Comprehensive Regional Telehealth Strategy 12 Clinically owned thresholdsClinical Thresholds Dementia Evidence Based Commissioning System Wide Incentive Staff Productivity Future Commissioner Landscape Future Provider Landscape Urgent Care Best practice and analysis of key success factors Advice on the key system changes Local implementation plans Regional policy gateway Set of regionally owned workforce and human resources metrics and trajectories New contract framework for non-elective services and long-term conditions Think Tank pieces and briefings Doncaster as a test bed Model for new commissioning landscape Models for the provider landscape
    7. 7. What do local plans tell us?
    8. 8. Some specific areas of potential • Falls • Dementia • COPD • Diabetes: t-health
    9. 9. Falls Prevention • Pathway for Paramedics • North Yorks County Council Pathway • Falls Co-ordinator • Fracture Liaison Service
    10. 10. ROTHERHAM COMMUNITY HEALTH SERVICES Intermediate Care ServicesTE CARE SERVICES INTERMEDIATE CARE SERVICES • Evidencing Quality, Innovation, Productivity and Prevention (QIPP) • Promoting a model of care that develops alternatives to admission, reduced length of stay and care closer to home • Delivering an interdisciplinary approach to care • Demonstrating best practice and improved health and wellbeing
    11. 11. Description of Rotherham’s Service • A joint commissioned service by NHS Rotherham and Rotherham Metropolitan Borough Council (RMBC) • Delivered by RCHS and RMBC Providers Providing: • Residential rehabilitation services • Day rehabilitation services • Community rehabilitation services Delivering: • 6 x week rehabilitation programmes Team: • Joint Clinical Lead – OT and PT • PTs, OTs, Social Care Officers, Support Workers, Home Care Enablers, Therapy support workers
    12. 12. Community Rehabilitation Service Team: • PTs, OTs and Home Care Enablers Delivering: • Rehabilitation to clients in their homes • Improving/maintaining independence and function • Supporting carers and decreasing dependence • Maximising abilities, reducing care packages • Improving health and wellbeing • Client centred treatment plans
    13. 13. Intermediate Care Services Productivity Assumptions 2008/9 - following teams intervention impact on social care packages: • Reduction of = 578 hours • Cost of care = £11.50 per hour • Saving in care = £345,644 2009/10 prediction based on 9 months data: • Reduction of = 827 hours • Cost of care = £11.90 per hour • Saving in care = £507,244 • Deliverability = 3 (achievable 2 - 3 years) • Level of evidence = 4 (research evidence NICE L2)
    14. 14. Intermediate Care Services Key Performance Indicators NI 125 at 91 days post discharge from IC services and NHS Rotherham Vital sign 04 • % of people living at home = 84.26% (target 81% top quartile) • % of people where health/condition has improved/stable = 97% • % of people reported that the service was good or excellent = 98%
    15. 15. ROTHERHAM COMMUNITY HEALTH SERVICES Description of Care Homes Liaison Service • Commissioned by NHS Rotherham • Delivered by RCHS Adult Therapy and Adult Nursing Services Providing: • Planned, targeted support to residential and nursing homes By: • Working in partnership with Care Homes Managers and Care Home Staff • Developing a culture of person centred care • Maintaining health and wellbeing • Promoting independence and where ill health is avoided or acted on appropriately
    16. 16. Care Homes Service Delivering: •Advice and support in the management of residents with complex needs •Screening and identification of physical and mental health needs •Assessments, training and rehabilitation •Multi-factorial falls assessments and falls prevention strategies Team: •Joint Clinical Lead – Clinical Specialist OT-Older people and Community Matron •PTs, OTs, SALTs, Dietician, Generic Support Workers, Reviewing Officer, Community Psychiatric Nurse
    17. 17. Care Homes Liaison Service Productivity Assumptions 2008/9 - 440 admissions to hospital from 6 x Care Homes (449 beds) (Cost of admission = £1,389,520) From April 2009 - December 2009 - following teams intervention: Admissions = 261 (Cost of admission) = £824,238
    18. 18. Care Homes Liaison Service Productivity Assumptions 2009/2010 prediction: • Admissions = 330 • Cost of admissions = £1,042,140 • Cash releasable = £347,380 • Deliverability = 3 (achievable 2-3 years) • Level of evidence = 4 (NICE L2)
    19. 19. Care Homes Liaison Service Key findings from review of 2 Care Homes by NHSR Commissioning team following teams interventions: • 90% reported that the service was either good/excellent • “training around falls was brilliant - made us think more about why people fall and preventing hospital admissions • “Safe feeding and position training was excellent - now have dedicated meal times and this has minimised weight loss for some residents” • “Care plans have now been adapted which are much more personalised to meet residents needs” • The training on tissue viability was excellent - this has empowered staff to identify problems with skin tissue and refer onto services quicker”
    20. 20. The White Paper • NHS Vision • GP Consortia • NHS Commissioning Board • Local Authorities • Foundation trusts
    21. 21. Key Themes • Putting Patients first • Improving Healthcare Outcomes • Autonomy, accountability, democratic legitimacy • Cutting bureaucracy, improving efficiency
    22. 22. What do AHPs need to do? • Get organised • Be Strategic • Be Coherent • Added Value – be succinct • Have a narrative
    23. 23. NHS Networks Healthcare Professions Commissioning Network http://www.networks.nhs.uk/nhs-networks/healthcare- professionals-commissioning-network Katherine Andrews NHS Networks Katherine.andrews@networks.nhs.uk Tel 07805 027463
    24. 24. Thank you Elizabeth Foley Elizabeth.foley@yorksandhumber.nhs.uk

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